County leaders discuss doctor shortage in region

December 30, 2012

Editor's note: this is the first of a two-part series on health care in Chautauqua County.

An appointment to see a doctor could land you on a waiting list lasting several weeks - or, in some cases, months.

Many people who are finding themselves on waiting lists to see a physician, dentist or mental health professional are learning first hand about Health Professional Shortage Areas, otherwise known as a HPSA designation.

"I definitely don't think we have enough doctors," said Ann Abdella, executive director for the Chautauqua County Health Network. "We have what are called health professional shortage area designations by the federal government for behavioral health, dental health, and we are actually working right now on surveying the physicians for primary care. Currently, we have what is called a HPSA designation for primary care. It's only gone from bad to, I think, worse in the last three years."

According to the U.S. Department of Health and Human Services, as of November of this year there are 5,805 primary care HPSAs in America, with 55.3 million people living in those areas. It would take 15,431 practitioners to meet the need for primary care providers, with a population to practitioner ratio of 2,000 to one.

Additionally, there are 4,534 dental HPSAs, with 44.6 million people living in them. It would take 8,962 practitioners to meet their need for dental providers, with a population to practitioner ratio of 3,000 to one.

Finally, there are 3,760 mental health HPSAs with 89.3 million people living in those areas. To remedy this, it would take 5,972 practitioners to meet their need for mental health providers, with a population to practitioner ratio of 10,000 to one.

"I am not sure when our area was initially designated as a physician shortage area, but I would guess it has been years," said Dr. Lillian Vitanza Ney, Health Care Action Team chair. "I do know that it was shown in 2008 in a Community Needs Assessment in 2008, published by Chautauqua Opportunities, and the shortage was verified in 2012 by the Volunteer Hospital Association study, and HANYS-Hospital Association of NYS. The shortage is nothing new, it has been quite longstanding."

According to Abdella, there are two designations within Chautauqua County for primary care shortages, The first is a geographic HPSA, which is a ratio of one doctor for every 3,500 people that live in an area, Abdella said.

"We have a geographic HPSA that runs almost like a rainbow around the county," she said. "That goes from Ripley, Panama, Harmony, all the way north of Gerry and Sinclairville, over to the eastern border like Cherry Creek to Arkwright, Forestville, that's a geographic HPSA."

Additionally, Abdella described a low-income HPSA, which includes several areas within the county, such as the town of Carroll, Jamestown, Gerry and the southeastern area of the county.

Because of the recognized shortages, the Health Care Action Team has prioritized the need for physicians within the community. In May, the committee recognized primary care as the highest need in the county. Ear, nose and throat physicians and surgeons were second on the list. The committee also recognized the need for orthopedics, neurology and OB/GYN.

"Deciding one day that you need a doctor, you can't go out and get one just like that, like you can get a piece of clothing or a refrigerator or something like that," Dr. Ney said. "Their training program is so long that once you identify a need and try to develop a relationship with that person and communicate with them and try to lure them to come into your community, it takes a long time."